| NPI | 1588618912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA S. VANDERHOOF Office Manager 231-775-1268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2012-12-07 |